2018-11-06T08:15:46-06:00 2017-12-31 221478099 COHNREZNICK LLP 4 BECKER FARM ROAD ROSELAND NJ 07068 990 2017-01-01 141628237 HUDSON HEADWATERS HEALTH NETWORK HUDS 5187610300 9 CAREY ROAD QUEENSBURY NY 12804 CHRISTOPHER TOURNIER CFO 5187610300 2018-11-05 1 LORI ROTHE YOKOBOSKY CPA P01273422 9732283500 2018-10-31 209.3.217.20 2018-11-05 13:48:24 ES P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 238159564A7F207AC3E2D33505B4833284B8AC6F 2017 2018-06-14 16:35:46Z DAVID T SLINGERLAND MD 9 CAREY ROAD QUEENSBURY NY 12804 107581880 0 X WWW.HHHN.ORG X 1981 NY FQHC - OUR MISSION IS TO PROVIDE THE BEST HEALTH CARE AND ACCESS TO THAT CARE FOR EVERYONE IN OUR COMMUNITIES. 17 17 929 29 3266226 -24437 10636423 15819243 58683298 62744882 31205 -30521 25352255 28978519 94703181 107512123 0 0 0 0 58060131 63286243 0 0 0 27617128 30294554 85677259 93580797 9025922 13931326 73659647 94044254 24893201 32346482 48766446 61697772 X WE ARE A COMMUNITY BASED HEALTH CLINIC WHICH SERVICED 82,866 PATIENTS IN 2017. TO FURTHER THE PROVISION OF COMPREHENSIVE HEALTH CARE SERVICES TO THE GENERAL POPULATION OF WARREN, WASHINGTON, SARATOGA, HAMILTON AND ESSEX COUNTIES. TO PROMOTE, SPONSOR, FOSTER AND DELIVER PROGRAMS, ACTIVITIES AND SERVICES WHICH SHALL HAVE THE PURPOSE OF IMPROVING THE HEALTH AND WELL-BEING OF THE POPULATION SERVED BY THIS CORPORATION AND TO CONTINUALLY SEEK NEW AND INNOVATIVE METHODS OF IMPROVING HEALTH CARE DELIVERY AND ITS FINANCING TO THE COMMUNITY SERVED. TO CARRY OUT ANY EDUCATION AND TEACHING ACTIVITIES RELATED TO RENDERING HEALTH CARE OR TO THE PROMOTION OF HEALTH THAT IN THE OPINION OF THE BOARD OF DIRECTORS MAY BE JUSTIFIED BY THE FACILITIES, PERSONNEL, FUNDS OR OTHER RESOURCES THAT ARE FOR, OR CAN BE, MADE. 0 0 75287983 87626459 THE CENTER IS A COMMUNITY BASED HEALTH CENTER CLINIC WITH MULTIPLE LOCATIONS. IN 2017, WE SERVICED 82,866 PATIENTS WITH 369,281 VISITS. 5978704 700688 340B PHARMACY PROGRAM - AS A FEDERALLY QUALIFIED HEALTH CENTER WE ARE ABLE TO ACQUIRE DRUGS AT THE LOWER PRICES MANDATED BY THE FEDERAL 340B DRUG PURCHASING PROGRAM, THIS ALLOWS US TO ASSIST INDIGENT PATIENTS WITH THE SOMETIME OVERWHELMING COSTS OF PRESCRIPTION MEDICATIONS. FACILITATE THE HUDSON HEADWATERS HEALTH NETWORK PATIENT ASSISTANCE PROGRAM WHICH ENABLES NEEDY PATIENTS TO RECEIVE MEDICATIONS FREE OF CHARGE FROM THE DRUG MANUFACTURERS AND GENERATE REVENUE TO SUPPORT HHHN'S OVERALL OPERATIONAL VIABILITY. 81266687 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 0 0 0 1 63 0 1 929 1 1 1 0 0 0 0 0 0 0 0 0 X 17 17 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 0 0 NY X AMY GERSTEN 5187610300 9 CAREY ROAD QUEENSBURY NY 12804 AMY LANGWORTHY BOARD MEMBER 1.00 0.10 X 0 0 0 BARBARA SWEET BOARD CHAIR 1.00 0.10 X X 0 0 0 BRUCE CARR BOARD MEMBER 1.00 0.10 X 0 0 0 CATHY MOSES SECRETARY 1.00 0.10 X X 0 0 0 CELINE RACINE-PAQUETTE EXECUTIVE COMMITTEE MEMBER 1.00 0.10 X 0 0 0 DANA HOGAN BOARD MEMBER 1.00 0.10 X 0 0 0 EILEEN HAYNES BOARD MEMBER 1.00 0.10 X 0 0 0 EUGENE ARSENAULT TREASURER 1.00 0.10 X X 0 0 0 HARRY ROBINSON BOARD MEMBER 1.00 0.10 X 0 0 0 IKE WOLGIN VICE-CHAIR 1.00 1.10 X X 0 0 0 JIM MORRIS BOARD MEMBER 1.00 0.10 X 0 0 0 KEVIN PORPORA BOARD MEMBER 1.00 0.10 X 0 0 0 MICHAEL MCCARTHY BOARD MEMBER 1.00 0.10 X 0 0 0 MILDRED ANZALONE BOARD MEMBER 1.00 0.10 X 0 0 0 PATRICIA ALLEN BOARD MEMBER 1.00 0.10 X 0 0 0 PATRICIA HUNT BOARD MEMBER 1.00 0.10 X 0 0 0 PETER REALE BOARD MEMBER 1.00 0.10 X 0 0 0 WILLIAM O'DWYER OUTGOING BOARD MEMBER 1.00 1.10 X 0 0 0 CHRISTOPHER TOURNIER CFO 40.00 1.10 X 259036 0 30498 DAVID T SLINGERLAND MD DEPUTY CEO/CEO 40.00 1.10 X 276152 0 29400 DOMINICK BIZZARRO PRESIDENT/CAO 40.00 X 118541 0 6807 JOHN RUGGE MD OUTGOING CEO/EXECUTIVE CHAIRMAN 40.00 1.10 X 456045 0 31756 DANIEL LARSON MD CMO EMERITUS 40.00 X 320348 0 27457 EDWARD SHANNON CDO 40.00 X 195877 0 27730 GEORGE PURDUE OUTGOING CAO 40.00 X 206644 0 15182 JOHN SAWYER MD CMO 40.00 X 296866 0 28319 PAUL BACHMAN MD OUTGOING CMO/CQO 40.00 X 270832 0 19174 ERIK D ISTRE PHYSICIAN 40.00 X 269169 0 20523 MICHAEL FULLER MD PHYSICIAN 40.00 X 265405 0 30089 RICHARD BRYAN PHYSICIAN 40.00 X 309059 0 7061 THOMAS PORTUESE MD PHYSICIAN 40.00 X 271939 0 34340 WILLIAM PARKER MD PHYSICIAN 40.00 X 279192 0 29305 3795105 0 337641 128 0 1 0 RICHARD E JONES ASSOCIATES 339 AVIATION RD QUEENSBURY NY 12804 ARCHITECTURAL AND ENGINEERING SERVICES 603155 T&J ELECTRICAL ASSOCIATES LLC 5 FAIRCHILD SQUARE CLIFTON PARK NY 12065 ELECTRICAL WORK 455394 ANN R PURDUE 11 MACORY WAY GANSEVOORT NY 12831 LEGAL SERVICES 161588 ADIRONDACK APOTHECARY LLC 1081 MAIN ST PO BOX 458 SCHROON LAKE NY 12870 CONSULTING SERVICES 117000 COHNREZNICK LLP 1301 AVENUE OF THE AMERICAS NEW YORK NY 10019 ACCOUNTING/TAX SERVICES 106417 6 311008 10392142 5116093 270000 15819243 OTHER THIRD-PARTY PAYORS 621400 22882578 22882578 MEDICARE 621400 14613207 14613207 MEDICAID MANAGED CARE 621400 7934991 7934991 SELF-PAY 621400 6582895 6582895 NEW YORK STATE MEDICAID AND MEDIC 621400 6147040 6147040 4584171 4584171 62744882 39236 39236 130028 0 130028 130028 130028 69757 -69757 -69757 -69757 PHARMACY 621400 24608989 24608989 340B CONSULTING 541610 3957369 700668 3256701 MEANINGFUL USE 621400 246500 246500 35633 26108 9525 28848491 107512123 88327147 3266226 99507 2627660 2371039 256621 47348649 42724164 4624485 1993444 1798915 194529 7513174 6780007 733167 3803316 3432172 371144 251151 251151 178546 178546 7179040 4739313 2439727 357945 193657 164288 473684 321068 152616 964017 194541 769476 2307711 2100603 207108 397699 293627 104072 126457 93365 33092 454011 454011 2726761 2151153 575608 374707 189180 185527 340B SUPPLIES 5978704 5978704 MEDICAL SUPPLIES 2961907 2961907 PROVISION FOR BAD DEBT 2107868 2107868 OTHER 1621529 802055 819474 1832817 1579338 253479 93580797 81266687 12314110 0 511313 180273 13641604 27358031 156552 1144064 10869391 11572645 350000 350000 638768 1197009 62920676 14603160 43330436 48317516 1000000 0 270000 270000 2891583 3654716 73659647 94044254 12521098 13870264 109936 6298709 11842099 3092560 3000088 2870898 3634031 24893201 32346482 X 48766446 61697772 48766446 61697772 73659647 94044254 X 13931326 -1000000 X X 0 1 X 1 1 1 X 3277150 3277150 33558443 6000877 27557566 4212723 2260397 1952326 6794435 2591772 4202663 15077925 3750114 11327811 48317516 DEFERRED COMPENSATION PAYABLE (457B) 3634031 3634031 X 104647201 21948 -2886870 -2864922 107512123 0 107512123 91755013 21948 -1847732 -1825784 93580797 0 93580797 PART X, LINE 2: THE COMPANIES HAVE NO UNRECOGNIZED TAX BENEFITS AT DECEMBER 31, 2017. THE COMPANIES FEDERAL AND STATE INFORMATION RETURNS PRIOR TO CALENDAR YEAR 2014 ARE CLOSED AND MANAGEMENT CONTINUALLY EVALUATES EXPIRING STATUTES OF LIMITATIONS, AUDITS, PROPOSED SETTLEMENTS, CHANGES IN TAX LAW AND NEW AUTHORITATIVE RULINGS. THE COMPANIES RECOGNIZE INTEREST AND PENALTIES ASSOCIATED WITH TAX MATTERS AS OPERATING EXPENSES AND INCLUDE ACCRUED INTEREST AND PENALTIES WITH ACCRUED EXPENSES IN THE CONSOLIDATED STATEMENT OF FINANCIAL POSITION. PART XI, LINE 2D - OTHER ADJUSTMENTS: RELATED PARTIES REVENUE 242,973. INTERCOMPANY ELIMINATIONS -21,975. IMPAIRMENT LOSS ON INVESTMENT IN ACO -1,000,000. PROVISION FOR BAD DEBTS -2,107,868. PART XII, LINE 2D - OTHER ADJUSTMENTS: RELATED PARTIES EXPENSES 282,111. INTERCOMPANY ELIMINATIONS -21,975. BAD DEBT EXPENSE -2,107,868. X X X X 0 0 0 0 0 0 0 1 0 CHRISTOPHER TOURNIER CFO 196775 0 30270 0 31991 0 12175 0 20058 0 291269 0 0 0 DAVID T SLINGERLAND MD DEPUTY CEO/CEO 259551 0 15097 0 1504 0 13276 0 17749 0 307177 0 0 0 JOHN RUGGE MD OUTGOING CEO/EXECUTIVE CHAIRMAN 340569 0 90866 0 24610 0 13350 0 20575 0 489970 0 0 0 DANIEL LARSON MD CMO EMERITUS 192167 0 100269 0 27912 0 13350 0 15970 0 349668 0 0 0 EDWARD SHANNON CDO 127132 0 28308 0 40437 0 9673 0 19900 0 225450 0 0 0 GEORGE PURDUE OUTGOING CAO 113755 0 91800 0 1089 0 11588 0 4637 0 222869 0 0 0 JOHN SAWYER MD CMO 258203 0 12741 0 25922 0 10196 0 19701 0 326763 0 0 0 PAUL BACHMAN MD OUTGOING CMO/CQO 156827 0 90635 0 23370 0 12954 0 8120 0 291906 0 0 0 ERIK D ISTRE PHYSICIAN 246611 0 22165 0 393 0 1900 0 20295 0 291364 0 0 0 MICHAEL FULLER MD PHYSICIAN 154357 0 104882 0 6166 0 13334 0 18265 0 297004 0 0 0 RICHARD BRYAN PHYSICIAN 304135 0 4221 0 703 0 0 0 8817 0 317876 0 0 0 THOMAS PORTUESE MD PHYSICIAN 157998 0 95716 0 18225 0 13350 0 22603 0 307892 0 0 0 WILLIAM PARKER MD PHYSICIAN 126287 0 142157 0 10748 0 13182 0 17736 0 310110 0 0 0 PART I, LINE 7 THE ORGANIZATION PROVIDED BONUSES TO VARIOUS OFFICERS, AND HIGHEST COMPENSATED EMPLOYEES. THESE AMOUNTS ARE INCLUDED IN SCHEDULE J, PART II, COLUMN B(II). A COUNTIES OF WARREN & WASHINGTON CIVIC DEVELOPMENT CORPORATION 383853734 2014-12-16 6500000 LAND, FACILITY & EQUIPMENT FOR HEALTH CENTER 0 0 0 B CLINTON COUNTY CAPITAL RESOURCE CORPORATION 452521133 2015-12-18 6500000 LAND, FACILITY & EQUIPMENT FOR HEALTH CENTER 0 0 0 A 502393 6500000 154168 6345832 2015 0 0 1 1 B 655508 6500000 146845 5853155 500000 0 0 1 1 A 0 0 0 0 0 0 0 B 0 0 0 0 0 0 0 A 0 0 0 0 0 0 0 0 0 B 0 0 0 0 0 0 0 0 0 A 0 B 0 X 1 270000 APPRAISED VALUE 0 0 0 PART I, COLUMN (B): AMOUNTS IN COLUMN B REPRESENT THE NUMBER OF CONTRIBUTORS. FORM 990, PART VI, SECTION B, LINE 11B AN INDEPENDENT ACCOUNTANT PREPARES THE 990. AFTER PREPARATION, A COPY OF THE DRAFT RETURN IS PROVIDED TO THE BOARD MEMBERS VIA EMAIL OR AT A BOARD MEETING PRIOR TO SUBMISSION WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION REGULARLY AND CONSISTENTLY MONITORS ITS' CONFLICT OF INTEREST POLICY WITH AN ANNUAL UPDATE OF ALL INTEREST THAT COULD POTENTIALLY LEAD TO A CONFLICT OF INTEREST FOR ALL EMPLOYEES. IF A CONFLICT OF INTEREST POTENTIAL IS RECOGNIZED THE BOARD SHALL DETERMINE WHETHER A CONFLICT EXISTS AND WHETHER SUCH DIRECTOR SHOULD ABSTAIN FROM VOTING. FORM 990, PART VI, SECTION B, LINE 15A THE BOARD OF DIRECTORS SETS COMPENSATION FOR THE CEO. THE CEO SETS THE COMPENSATION FOR MEMBERS OF SENIOR MANAGEMENT. THE ORGANIZATION ALSO USES A SURVEY WHERE POSSIBLE, COMPARABLE POSITIONS WITHIN THE REGION, COMPENSATION CONSULTANTS AND BOARD REVIEW. COMPENSATION IS DETERMINED BY A COMBINATION OF SENIOR MANAGEMENT, FINANCE AND HUMAN RESOURCES TO ENSURE FAIRNESS AND CONSISTENCY IN SETTING PAY RATE AND BENEFIT LEVELS. FORM 990, PART VI, SECTION C, LINE 19 DOCUMENTS ARE AVAILABLE UPON WRITTEN REQUEST. THEY ARE MADE AVAILABLE AT OUR ADMINISTRATIVE OFFICE AT 9 CAREY ROAD, QUEENSBURY, NY. FORM 990, PART XI, LINE 9: IMPAIRMENT LOSS ON INVESTMENT IN ACO -1,000,000. FORM 990, PART XII, LINE 2C: THE SELECTION AND OVERSIGHT PROCESS DID NOT CHANGE FROM THE PRIOR YEAR. FORM 990, PART IV, QUESTION 20A: THE ORGANIZATION IS LICENSED UNDER ARTICLE 28 OF NEW YORK STATE PUBLIC HEALTH LAW. HOWEVER, SUBSECTION 10 OF ARTICLE 28 EXCLUDES CERTAIN HEALTHCARE FACILITIES FROM THE DEFINITION OF GENERAL HOSPITAL. THEREFORE, THE ORGANIZATION IS NOT INCLUDING SCHEDULE H IN THE CURRENT YEAR FORM 990 AS THEY DO NOT MEET THIS DEFINITION. 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